The natural vitamin E family is composed of eight members, equally divided into two classes; tocopherols (TCP) and tocotrienols (TE). TCP are characterized by a saturated phytyl side chain with three chiral carbons whereas TE possess a farnesyl side chain with double bonds at carbons 3, 7, and 11. Within each class, isomers are differentiated by α, β, γ, and δ according to the position and degree of methylation on the chromanol head. TCP represent the primary form of vitamin E in green leafy vegetables, while TE are found in highest concentration in seeds of monocotyledons that include the wheat, rice, oat, barley, and palm.
Clinical trials testing the effects of vitamin E in a wide range of major health disorders have come to the general conclusion that vitamin E either is not helpful or could be harmful under certain conditions. Meta-analyses of over 20 randomized, controlled clinical trials testing vitamin E have now reached conclusions that on one hand serve the basis for readjusting public policies and practices while on the other suffer from a major blind spot which is not recognized in any of these reports. While title claims of such meta-analyses address vitamin E as whole, they fail to recognize that the form of vitamin E studied in the vast majority of these trials is α-tocopherol which represents one-eighth of the natural vitamin E family.
Vitamin E is a fat-soluble vitamin that exists in eight different forms. Each form has its own biological activity, which is the measure of potency or functional use in the body. Vitamin E is a dietary antioxidant that assists in maintaining cell integrity. It is obtained from sunflower, safflower, canola, and olive oils; also from many grains, nuts, fruits as well as fatty parts of meats. The tocotrienol form of natural vitamin E is found in rice and cereals but more abundantly in palm oil. Palm oil is an integral part of daily diet in southeastern Asia.
Palm oil represents a major source of natural tocotrienol. Tocotrienol compounds possess powerful neuroprotective, antioxidant, anti-cancer and cholesterol lowering properties that often differ from the properties of tocopherol. Micromolar amounts of tocotrienol suppress the activity of HMG-CoA reductase, the hepatic enzyme responsible for cholesterol synthesis. The unsaturated side chain of tocotrienol allows for more efficient penetration into tissues that have saturated fatty layers such as the brain and liver. Comparative examination of the antioxidant properties of tocopherol and tocotrienol revealed that tocotrienol is advantageous because of a better distribution in the fatty layers of the cell membrane. Like tocopherol, tocotrienols have been identified to possess distinct functions that may benefit human health, yet tocotrienol accounts for a very small fraction of overall vitamin E research.
Hot flashes, also referred to as vasomotor symptoms (VMS), typically begin as a sudden sensation of heat centered on the face and upper chest that rapidly becomes generalized. The sensation of heat lasts between two and four minutes, is often associated with profuse perspiration and occasionally palpitations, and is often followed by chills and shivering. Hot flashes cause arousal from sleep, leading to sleep disturbances.
Hot flashes occur in 75% of menopausal women in the United States. The flashes most often begin in the pen-menopausal period, although in some women they do not begin until after menopause. Hot flashes usually occur several times per day, although the range may be from only one or two each day to as many as one per hour during the day and night. More than 80% of women who have hot flashes will continue to have them for more than one year. Untreated, hot flashes stop spontaneously within a few years of onset in most women. However, some women have hot flashes that persist for many years.
Hot flashes occur in about 70-80% of men undergoing androgen deprivation therapy in the treatment of prostate cancer. Men who develop hot flashes during temporary androgen deprivation usually recover within a few months of stopping treatment, however men receiving permanent androgen deprivation therapy may have persistent recurring hot flashes.
Hot flashes have been treated with hormone therapy, antidepressants, anti-seizure medications, and palliative care. However, many of these treatments may be contraindicated for some patients. There is an unmet need for further treatment options that are safe and effective.